tavis: good evening. from los angeles, i am tavis smiley. tonight, we begin a new series, called road to health. it is a look at how we can rebuild help the communities. my guest heads of the ucla health sciences department and is host of an upcoming pbs series called "designing help the community's." it is often the poor and disenfranchised who suffer the most due to environmental health problems. we are glad you can join us, a conversation with dr. richard jackson, coming up right now. >> every community has a martin luther king boulevard. it's the cornerstone we all know. it's not just a street or boulevard, but a place where walmart stands together with your community to make every day better. >> the california endowment. help families and neighborhoods. learn more.

>> and by contributions to your pbs station from viewers like you. thank you. captioned by the national captioning institute --www.ncicap.org-- tavis: each month this year, we are pleased to bring you a conversation about health and health care issues. tonight, we kick off the series with dr. richard jackson, former director of the national center for environmental health at the cdc. he served as chair of the environmental health sciences department at ucla and hosts "designing health and communities." >> we are looking at the first generation in american history to have a shorter life span than

their parents. on this episode of "designing help the communities -- healtahy communities," i am going to look at diabetes and suburban sprawl. >> i went in for some treatment. they said i was going to take my foot off. >> in epidemiology, we call it a common source epidemic when everyone develops the same set of symptoms. it is not something in their mind. it is the environment changing health. we will see communities combating type 2 diabetes, not through medication and education, but redesigning our car-centered society. the time has come for the retrofitting of suburbia. tavis: it is excellent to have you on the program. >> nice to meet you. tavis: a simple question. when you say designing healthy

communities, how do you go about it? >> we have essentially build -- we build because an investor put something somewhere. for too long, we have not thought about what we do to make people healthy. for a long time, i was the director of the national center for environmental health. i worry about toxins and climate change. 10 years ago, i came to the conclusion that what really impacts people is where they live, the home they are in, the community they are in. for too long, we worried about things far away or very small. time to think about building things that work for people. tavis: i suspect there are certain places in this country that are better to live, vis-a- vis health, and other places. >> if you tell me where you live, i can tell you how long you will live. in alameda county, where oakland is, it is 15 years difference

between the poor, parts of town and people in the more favored parts of town. 15 years. being poor. being in environments that do not have health the places where you can buy food, that do not have a green space, that do not have safe places to walk -- that is a risk for your life span. tavis: what is to be done about that? it takes resources to live in those places. i suspect in alameda county, where you can get an extra 15 years in your life, and people living in places where they are denied 15 years -- they would go across the bridge if they had the resources. >> to do this series, we visited a dozen series -- a dozen places around the united states. one was the healthiest city in the healthiest state, boulder, colorado. it has a more favored population in terms of economy and

education. people live a long time. people can go about their lives without getting in a car, week in, week out. we visited places that were really challenged. the huge city of detroit has about one-third -- has about 1/3 the population it had 30 years ago. until recently, the city of detroit did not have a single supermarket. trying to think how a city that has been devastated by the wealthy population moving out and buy a series of other issues in the economy largely moving overseas -- how do cities come back? in the population of detroit, one of the big things that happened was a farmer's market. it has gotten bigger and bigger. people can get healthier food. the of putting bike lanes into that and building community gardens. those are owned by the community. that is real work, generating income, building community.

that is how we have to turn it around. tavis: why is bolder such an example, and cannot be scaled up? >> there is a university there with a stable income. not everyone can be bolder. on the other hand, it has creeks and streams running through it that have bike trails or walking trails. the bike trails were put in place going the other way. it brought people into town. one of the cities we visited was elgin, illinois. it was your classic rust belt town. the use to make watches. the business went out of downtown became a ghost. people moved out and live 5 miles from each other and shopped in big bookstores. they decided to rebuild downtown, around the library, with bicycle routes. the reclaimed the fox river.

there are walking trails and parks. they had to do something important. they had to bring in people of diverse incomes downtown. this was not about so-called gentrification, bringing in people who are well off. you have to have a real mix of that population to create a real community. what i tell my students in class is -- if you want to rebuild community, you have to have the hardware and software. the hardware is a hard scape, the roads and bike lanes, the safe buildings, hopefully energy efficiency. but you have to have the software, community ownership. the community often has wisdom about what works best there. >> this is my word, not yours, but where we live is a very personal choice. people want to be empowered to have agency. they want to have the agency, to use that word, to decide where

they want to live. i get that. i would not want to be told where to live. how do you -- my word -- coerce people to live together in downtown l.a. and or other places, and what are the benefits for people of diverse backgrounds and perverse incomes living together? how do you make it happen? >> i thought a lot about the word or give back. when we think about organic plants, they are adapted to the soil, water, and sound patterns. what works in one place will not work in another. the community has to decide what they want. we say people decide where they live. that is not really true. a lot of us live where we live because that is where we were going and that is where our friends are. for a lot of us, we would love to live closer to manhattan or berkeley, but we cannot afford

anything there. we end up driving 50 or 60 miles. real-estate people say drive until you qualify. it is the economics that is determining where people live. the other big driver is schools. people pick where they are going to live. is it safe, can i afford it, and are the schools could? i would argue we have removed people's agency and ability to have the choice. i might think i want to have a yard and a lawn. i want to have this neighborhood. but if i moved out to the central valley of california, there are no walking trails. there is no infrastructure, no library or doctor's office. pretty soon, it gets lonely. think about a child growing up in a home where they need to ask for a ride every single time they want to go about their life.

tavis: what is the advantage of people in a place like elgin living together, where there is diversity in income and ethnicity? what is the value of that? >> tangibles and intangible values. one is the towns and cities that do best are the ones that attract bright and creative people. we see this over and over again. people want to live there. if you create a place bright young people want to come to, the services there get better. you begin to develop the tax base, restaurants, and services. the police services, trash services, all kinds of services. that diversity brings in the resources in policing. people say they do not want to live in a crowded place, and

then go on vacation to a place like paris or other cities that are very dense. i ate and ate and i did not gain any weight. why? i walked all the time. it was so interesting being there. i would argue you have toave diversity. it sounds cynical. but poor people need rich people. that is how the services come in. rich people need poor people because somebody has to do the work. they talk about the aspen syndrome, aspen, colorado. there is a huge traffic jam of people coming in to do work. i am not just talking day laborers. nurses, police officers, and teachers have to come into that town to provide service. imagine what it is like to grow up in a place like that, where the only people you see are very wealthy, very secure folks, but you do not get any experience of

the broader world. tavis: the son of an experiment in a place like elgin where you have mixed living is this -- i am hesitating. i want to refer to it as an old school motion, yet it is not that old. i was going to ask about these restrictive covenants for neighborhoods, where they would not let certain people live there. they did not want people to live in the neighborhood and had codes to keep you out. "the reason in the sun -- raisin in the sun" 'is an element of this in the play. a couple of years ago, eric holder was going after a particular community in the northeast where there were still engaged in this practice of keeping people out of this neighborhood. to what extent, if at all, is that part of the process in

certain areas? >> i think one would have to have one's head in the sand if we did not think racism played a large part in the depopulation of downtown detroit. if it did not have influences in other parts of the country. it took creative people to break down those barriers. it took smart attorneys and lawsuits. it took enforcement of the civil rights act. things are not perfect but a long shot. there are still parts of los angeles where it would be extremely difficult for people of certain racial and ethnic backgrounds to get in, unless they had a lot of money. when i was state health costs in california i lived in a development that was 1/4 the so- called affordable housing. i did not know which of my neighbors or section 8 housing. we got along perfectly well. one of the most foolish things we can do as a country is to isolate people -- put all the

poor people in one place, where house them. it does not work. we ended up tearing down housing developments. it does not work. we do not want children growing up in an environment. tavis: help me understand, with all the urban sprawl we have experienced in this country, why it is that what sounds to me like common-sense -- my grandmother might say this makes too much sense. how is it with all this urban sprawl in these tough cities that these kinds of considerations have not been on the table? >> i probably give a talk a week around the country for the last 10 years about this issue of the built environment and health. inevitably, someone says this sounds like common sense. people ought to live in energy- efficient homes near transit. every child ought to be able to walk or bicycle safely to school. you ought to have parked nearby. that is common sense. but why aren't we doing it?

i think there are a lot of structural reasons. we need to change the codes that decide what is going to go where. right now, we codify in lot residents should be over here, like business will be here, and heavy business will be here. there is no reason accountants' offices and light retail cannot be mixed into the community. that is what we did 80 years ago. it worked very well. when you separate it, you have to be in a car to do everything. we have to change the law. we have a tax structure that makes it very difficult for people to do this. there are small things and big things that have to happen. i would argue this is really why we went forward with this television series. maybe at the bottom we have to change our mind set, and we have to begin to realize, "i would be happy to be in a place where i did not have to hang on to a

steering wheel 60 miles a day and could spend that time with my children, my church, or my friends." many people in los angeles, the most stressful part of the day is their commute to work. it is not their jobs. we have become so married to our cars we have forgotten what makes us happy. tavis: if what you say makes sense, and it does, and you cannot be the first person saying this, what are the barriers? what do they say are the barriers to elected officials changing these laws, changing the codes, doing the things that need to be done? what do they suggest is the reason they cannot or have not? >> a big obstacle in a state like california, for example, and i realize it is bigger than that, is a lot of tax revenue

comes from big box stores, big car dealer lots. changing tax policies is big. there is a debate in northern new jersey about light rail that is the way to run along the hudson river. people in one of the towns do not want it there. the people further along want it there. the folks that have it love it, but it is a change. there are unfamiliar people coming in. we do not want the change. that is the sad news. the good news is i look at our young people and it gives me hope. what i am talking about in this series -- our young people are very worried about the world we are handing them. they are worried about jobs. they are worried about resources and climate change. they do not like the way things are going. what gave me great hope toward the end as i look at detroit. it is being read populated with

some of the most bright creative people. they are mixing with african american folks who have been there, with the barber shops and restaurants. people are getting along very well. i am finding young people can accommodate to this new world far better than the aging baby boomers. maybe that is the hope. the shelf life of human beings is short. this will take a generation. tavis: i like the example of detroit. i have been reading about what is happening which we population of not just african americans. how do you guard against- gentrification? that is to say, how do you guard against people feeling they are being pushed out? now that you can buy a home for $5, people are again being cast aside. how do you guard against that? >> in detroit, they will have to

take a fair number of the residual homes and cluster them into a real community. you cannot have a community if it looks like a scrabble board of isolated blocks here and there. this is interesting. in san francisco, there was an area that had about 200 very poor families living in substandard housing. a developer came in and said, "i am going to build a 1000 unit of hi and housing." the city said they would like the revenue, but you are going to put 240 affordable homes in there, and put the people in decent housing while they wait to move in. it was a battle, but in the and, that is what happened. people's rights when the changes occur have to be respected. we have to take care of them. they were part of the community before it became popular again. >> who is in the frontline of this fight?

are these local officials, state officials? this is something the federal government needs to engage in. >> one of the reasons we did this series is the average citizen needs to begin to understand this. my son is an internist. i am sitting there, dad, and we see 20, 30 patients a day between 5 and 10 have diabetes. they are very overweight, very out of shape. in the northwest. i write a prescription for their cholesterol, for their diabetes. i tell them to go out and exercise and eat sensibly. they live in neighborhoods where all you have is a store that sells beer. the cannot eat fruit and vegetables. they cannot go for a walk. my physician friends feel like sitting at the end of the disease pipeline, trying to patch up the casualties of a lifestyle that is doing serious harm.

we look at our young people, people going in 1980. they are three to four times more likely to be obese than the previous generations. average adult's gained 25 pounds from 35 years ago. 1% of all the money in the united states went to diabetes 10 years ago. now, 2% of gdp is going to diabetes. when i was a young pediatrician, i never saw a child with type 2 diabetes. it is adult onset. now, we are seeing kids 10, 15, 20 years old with diseases of 70 year olds, because of this obesity and lack of fitness. the physicians are looking at this and are worried. the generals in the u.s. military are worried, because two out of every seven recruits cannot get in because of obesity and lack of fitss. we have engineered healthy food

out of people's lives. we have engineered physical activity thru exercise out of people's lives. tavis: let me move toward the close by asking this question. how do you get traction on this issue with the right people? obviously, you have this wonderful series now on pbs. you have air time on pbs. you have talked to the right people about these issues. yet i am trying to juxtapose that against imby, -- nimby, not in my backyard. with the people where the good schools are -- the have to understand these dots are connected. what happens over there ultimately will impact me. but how do you get traction on this issue, with all due respect to pbs? we realize yous,

cannot be healthy if everyone around you is sick, with tuberculosis and other things. in the year 2012, you cannot be healthy if everyone around you is unhealthy. you cannot have an economy spending 20% of its money on medical care. there was an old line about the business of america is business. we have to get the corporate interests committed to this. i am not just talking about brainwashing -- greenwashing, where some corporate entity does some nice ads. i am talking about the next houses that need to be built. nobody wants to live in a cracker box. it is not safe and it is poorly heated and poorly insulated. sound goes through it. we need to build quality neighborhoods. it is a good business proposition. housing people said to me, "you should be fired because you are saying sprawl is bad."

i said, "i am saying something you will like. if 20 houses are developed on an acre, you will make more money than if you put one or two." tavis: let us hope that message gets through. the work is called "designing healthy communities." it is a pbs series. you see it on the screen. there is also a companion text by the same name. his name is dr. richard jackson. i am honored to have you on the program. thank you for the work you are doing, and all the best to you. that is our show for tonight. thanks for watching. until next time, keep the faith. >> we have an opportunity to do it right, so people will have more active lives, because it is easier and healthier. it is more fun. that is where we need to be next, wherever that is.

we will not know it until we discover it. we learn by trial and error, not because you who study the answer and carry it out. you have to live the answer and see what works and what does not. our goal is not to do this again 10 times, but to figure out what is next. i think the next generation will have the same urban principles about walkability, but smarter, greener, more humane, may be breaking out of the current traps where we categorize things as this is urban and this is not. >> for more information on today's show, a visit tavis smiley at pbs.org. tavis: michael hastings on his explosive new text "the operators," next time. >> every community has a martin luther king boulevard. it's the cornerstone we all

know. it's not just a street or boulevard, but a place where walmart stands together with your community to make every day better. >> the california endowment. health happens in neighborhoods. learn more. >> and by contributions to your pbs station from viewers like you. thank you.

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